My love for the medical establishment continues. I went to my annual physical last Wednesday, looking for a clean bill of health and a referral. Instead, I got orders to check my blood pressure five times a day and an uninformed dismissal of my referral request.

I have no doubt that my doctor is a well-intentioned man. He’d have to be, considering the way he dresses himself. Picture this: thirty-something, 5’11”, one hundred and fifty pounds, night-vision pale, dressed in a ratty blue oxford, a two-sizes-too-big checkered jacket, and olive slacks hemmed for an impending flood.

Clearly, this is a man more concerned with the practice of medicine than making the cover of GQ, a fact that I found reassuring—for approximately five minutes.

After the standard litany regarding smoking, safe sex, diet, and exercise, Doc strapped on the blood pressure cuff. 144/90. According to the device on my arm, I was a good four or five seconds from having a massive coronary, despite a resting heart rate of sixty beats per minute. This is an anomaly we revisit every time I throw down my $15 co-pay, and the standard prescription is to keep a log of blood pressure readings to inform future action.

Here’s the rub: I’m hypertensive by any medical standard. My blood pressure consistently tops 140/90, and the doctor’s playbook of pill popping will undoubtedly put me on some combination of ACE-inhibiting, beta-blocking, calcium-channel influencing diuretics that will kill me the next time I blast through a 21-round “Cindy”.

Granted, I can’t be sure Doc will put me on the ten-pill-a-day diet, but most of the other options are long gone. Changing my diet any further would have me killing squirrels in an attempt to get closer to my Paleolithic roots, more exercise would put me in the Guinness Book of World Records, and stress reduction would require me to take up chanting and yoga in my non-existent spare time.

Genetically, I’m a time bomb. My father’s heart explodes with a regularity that would make the tides jealous, and grandpa has had enough bypasses to receive an honorable mention in the Journal of the American Medical Association. Despite my lifestyle, I’m following in their tracks, one plodding step at a time.

Doc and I had covered this ground before without resolution, mostly due to his “medication first” style of healing. My blood pressure logs, transferred to his corpse-white hands, would invariably lead straight to the pharmacy. I only go to the pharmacy for toothpaste.

Fortunately, I had another solution. Here in Boston, we are blessed with an Active Release Techniques (ART) practitioner who also happens to be an M.D. That two-letter appellation means that my health insurance would pay for her stress- and blood pressure-reducing services, if only I could provide a referral from my physician.

I told Doc I’d like a referral, and quite reasonably, he asked me to explain ART.

“It’s a specialized massage technique used to correct soft tissue damage. Adhesions, pulls, tears, things like that. It restores muscle balance and range of motion through manipulation. My body takes a constant pounding in the gym, and this would help tremendously.”

I might as well have said I wanted to use heroin to treat my insomnia. His eyes narrowed, and he asked for the M.D.’s name and practice. He got it, but it was obvious I wasn’t getting my referral.

“You want physical therapy?” he asked. Shaking my head, I explained the idea one more time, getting into the details of fascia and trigger points. Asked if I had a particular pain, I unthinkingly slammed the door on my referral.

“I get tightness in my rotator cuffs, IT bands, TFL, and lower back.”

I hadn’t named a single disease, complained of pervasive pain, or given Doc a problem that fit anywhere within his neatly defined world. I hadn’t asked for pills, an MRI, or surgery. Stumped, he told me he’d need more information.

Ironically, he was exacerbating my hypertension.

My problem with the medical establishment is the same problem I have with nearly every entrenched authority—the marked inability to consider alternatives to conventional wisdom. Time after time, we find doctors with an unnatural affinity for the Physician’s Desk Reference and surgeons who believe every problem can be solved with a scalpel. The manual never mentions naturopathic remedies and soft tissue manipulation, so our doctors are left with a toolbox that’s missing a few screwdrivers. Even worse, the idea that there might be another screwdriver out there is met with more skepticism than the front page of the National Enquirer.

Next year, I’ll forgo the fifteen-dollar tour of the old guard, and make our friendly ART practitioner my primary care physician. When my blood pressure readings come in high, perhaps soft tissue work will be the first solution instead of the last.

Maybe then I’ll calm down.

Picture courtesy of admin.state.nh.us.